Protecting Against STIs: Barrier Method

Updates today include: updated information based on new research/resources, adding information about dental dams, and changing terms for condoms to the inclusive “external” and “internal” condoms. updated March 7, 2018.

 

Person stuff: I want to say thanks again to everyone who donated to help me fund my visit with my kids and to those who sent prayers/good wishes/thoughts our way. A very great time was had by all, including visiting family, hiking trips, museum trips, and catching a carnival.
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Okay, back to our regular programming.

As I mentioned in my last post, the well-known refrain in STI prevention is ‘barrier method’. Barrier method usually means a condom (external or internal), which prevents direct contact between the genitals. For all their problems, condoms are the only effective method for actually stopping several STIs jumping from one person to another. What many people do not realize is that a cervical cap can also be an effective barrier method against certain STIs. Every other method for preventing STIs is basically about making sure no one you are having sex with has currently-infectious STIs. (Exception: PrEP, which is specific to HIV/AIDS and will be covered in another post.)

CONDOMS

Condoms do not protect against all STIs. They do not protect 100% against the STIs they are effective against. However, they are probably the best thing going. External condoms and internal condoms offer different levels of protection against different STIs. The protection offered by external condoms has been more thoroughly studied, so consider the information on internal condoms incomplete pending further research.

External Condoms

External condoms (commonly called ‘male condoms’ or just ‘condoms’) are usually made of latex, though there are non-latex varieties for people with latex allergies. They go on over the penis and trap semen. They also prevent direct contact between the penis or sex toy and the vagina, anus or mouth during intercourse. (Yes, condoms can be used during oral sex as well if there is any chance one of you has an STI. They can also be used on shared sex toys to prevent STI transfer.) Here is a decent step-by-step guide to putting on an external condom.

External condoms provide protection against STIs transmitted through genital fluids, including:

  • HIV
  • chlamydia
  • gonorrhea
  • trichomoniasis
  • HPV

Depending on where the infection is, external condoms may provide protection against:

  • genital herpes
  • syphilis
  • chancroid

The CDC has the following advice for using external condoms:

  • Use a new condom with each sex act (i.e., oral, vaginal, and anal).
  • Carefully handle the condom to avoid damaging it with fingernails, teeth, or other sharp objects.
  • Put the condom on after the penis is erect and before any genital, oral, or anal contact with the partner.
  • Use only water-based lubricants (e.g., K-Y Jelly, Astroglide, AquaLube, and glycerin) with latex condoms. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) can weaken latex and should not be used.
  • Ensure adequate lubrication during vaginal and anal sex, which might require the use of exogenous water-based lubricants.
  • To prevent the condom from slipping off, hold the condom firmly against the base of the penis (or sex toy) during withdrawal, and withdraw while the penis is still erect.

Note – natural condoms (those made from natural membranes) are not effective in preventing STIs).

Internal Condoms

Internal condoms (commonly knows as “female condoms”) are made of nitrile and are inserted into the vagina or anus. A ring at the base of the condom is intended to it in place by the cervix. When using internal condoms for anal sex, care needs to taken to keep the condom in place. internal condoms flare at the top, covering part or all of the labia/butt. The best guide I’ve been able to find to using internal condoms is here. If you know of a better one, please let me know. Internal condoms should be used in the same circumstances as external condoms, but internal and external condoms should never be used together – the friction will cause one or both to break.

All the research I have found on internal condoms has been on vaginal use. They are probably just as effective for anal use, but we don’t know for sure.

Current research suggests that internal condoms offer protection against the same STIs that external condoms do. Research into how effective they are is ongoing.

Internal condoms cover a wider area than external condoms, and so may provide better protection against:

  • genital herpes
  • syphilis
  • chancroid

Except for the bit about removing the condom, the guidelines from the CDC above apply equally to internal condoms.

CERVICAL DIAPHRAGMS

Cervical diaphragms are caps that are placed over the cervix, so that semen cannot enter the uterus. Unlike condoms, cervical diaphragms are reusable and can last up to two years. Most information sources will say the diaphragms do not protect against STIs. This is debatable. Diaphragms definitely do not protect against the STIs that most often discussed. Diaphragms MAY protect against some STIs. (Sources: 1, 2, 3) A cervical diaphragm, as the name suggests, can ONLY be used for vaginal intercourse.

Cervical diaphragms may provide some protection against:

  • cervical gonorrhea
  • chlamydia
  • trichomoniasis

Diaphragms may be confused with cervical caps. Cervical caps are smaller than diaphragms, and do not provide protection against STIs.

It is worth noting that diaphragms definitely do NOT provide protection against HIV.

Dental Dams

Dental dams are squares of polyurethane or latex that are placed over the vulva or anus prior to oral sex. Use of a dental dam protects against STIs that can be transmitted through oral sex, including

  • herpes
  • genital warts
  • HIV

Dental dams should only be used once. If you don’t have or don’t have access to dental dams, you can make one out a latex external condom. DO NOT make a dental dam out of a non-latex condom, including all internal condoms, which are made of nitrile. (Saliva is a digestive fluid, it requires different types of barriers than genital fluids.) The CDC has a guide for making a dental dam out of an external condom.

Do you use a barrier method for STI protection? Please leave a comment on how your polycule uses barrier methods and your thoughts/feelings.

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